Speaking Up and Speaking Out

May 01, 2019

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Speak up! It’s absolutely essential for us to do that. If we see something we don’t like, we can’t remain passive. I think it’s very important to develop our own communication skills in order to know how to deliver our message effectively.

Angela Benefield

Angela Benefield, an education specialist/clinical consultant in Southern California, believes strongly in nurses advocating for one another. Benefield has been very active in AACN through her work in chapters, as an ambassador and as a member of various review panels. “Nurses do unbelievable, amazing work,” she says; “to me they’re just like the next best thing to angels.” At the same time, she believes that because the work nurses do is so fast-paced, they sometimes lose perspective on what is really important. Because of this, she tries to speak out about issues that are important to her and to other nurses — and she encourages other nurses to do the same.

You’re an effective advocate for nurses. Why is that important to you?

I believe that nurses are truly the most important thing in patient care. They work 24 hours — so they get to really know the patient very well. They get to see the changes rapidly before the physician does. I think most healthcare providers are patient advocates, but nurses really make outcomes happen. They’re the ones on the ground that change the situation all the time. They call physicians early on and prevent a lot of things. So I feel like we have to advocate for nurses on their behalf, because if their time with the patient is limited, if they don’t have the resources that they need, if they’re overstretched, something is going to give.

What are some of the issues that you see affecting nursing today?

Staffing. I think staffing is done a lot of times by electronic acuity systems that may pull data from nursing documentations. Sometimes, it doesn’t fully capture the patients’ needs, because a lot of times the required documentations may not be documented in real time in the chart, and the nurse is busy doing her actual work. As a result, acuity systems do not always capture the patient’s dynamic changes needed in planning for staffing, and in turn, it may indirectly impact staffing. This is why communication and frequent rounding are essential to ensure accurate staffing needs.

Nurses also have to have education and professional hours to grow, and I think a lot of organizations — because of budget constraints — have cut a lot of nurses’ professional time. So joining a professional organization, having the chance to attend conferences, to know why all these initiatives that they’re seeing at the bedside happen, is absolutely crucial to getting better patient outcomes. These initiatives change all the time, and nurses really have to understand why. Joining professional organizations where we get the latest evidence-based practice early on, I think that’s essential for nurses to be able to advocate for patients.

With so many opportunities to make an impact, how do you decide what issues to focus on?

There are many opportunities. You really have to assess what’s really going on, and that varies from organization to organization. But I think we have to look at what trends are happening in healthcare, and look at the evidence behind it. If you look at one organization and let’s say there are a lot of sentinel events in one area, we have to really dig deep and figure out what is the root cause. Unfortunately in a lot of hospitals what we do is remedy or patch a little bit, but we don’t really get to the root cause of the problems. We don’t get nurses involved early on to really address what happened. When you look at system issues, we have to focus on the structure, processes that are in place in order to get the outcomes, and a lot of times it’s not just one person causing an issue. So in order for us to make an impact, we have to really look globally, we have to look broadly beyond our organization, and what are the best practices that are out there that we can actually bring back and incorporate in our own organization. So we need to focus on national trends. Those are to me the most important things we need to be doing.

What should nurses do to stay informed about issues that affect them?

I think nurses have to come to the table, have to be involved. I really believe we have to be involved in professional organizations in order to get our voice heard, because a lot of times by talking to each other and really knowing each other’s challenges, then we really can begin to brainstorm solutions. And when we do, I think we also have to be engaged in saying how we can make a difference and affect outcomes. In order for us to be effective, we have to really know what the evidence is, we have to increase our education level, collaborate with each other, look at the system a little bit more broadly, widen our lens a little bit in order to see not just our own unit but what is the impact and the consequences for the whole organization. By preventing silos and collaborating, our strengths are multiplied to support each other.

What’s the value of social media when it comes to advocating for nursing?

I love social media because you can get immediate feedback. You can actually utilize it to test your ideas. You can share a lot of things fast. But I also think it can be a double-edged sword if you don’t really know what you’re posting on it. Nurses have to be cognizant of what they’re posting, because it’s public and everybody can see it. I like to use it more to support each other, to really learn a little bit more about my practice. My daughter is also a nurse, so she likes to communicate through Instagram and social media, and her communication style is a little bit different from mine. So I look at it as another forum. However, it’s not the only forum — I like face-to-face interaction — but it’s another way to communicate. So it adds some value to what we want to do … if we use it correctly.

How can chapters be effective advocates for nursing issues?

Chapters are really great places for advocating for nurses. I feel our chapters are like a mini AACN. It’s a really wonderful environment to connect nurses together outside the work setting. When you’re outside of work — when you’re not so busy and running day-to-day operations — it’s a lot easier to relax and innovate a little bit more. You also get to network with so many people from different places that you actually exchange ideas and best practices. So I believe chapters are well-positioned to start grooming new and seasoned nurses to become our future leaders. That’s huge!

What’s the best way for individual nurses to use their bold voice to advocate for their profession?

Speak up! It’s absolutely essential for us to do that. If we see something we don’t like, we can’t remain passive. I think it’s very important to develop our own communication skills in order to know how to deliver our message effectively. It’s not just about clinical skills. I think our relationship skills, communication skills — a lot of things that we were not taught in nursing school — are important to success in life. In many organizations, nurses are evaluated on clinical skills. But what I try to do in my environment is really develop both clinical and professional skills. Just like we need to take a holistic approach with patients, we need to take the same approach in developing each other — that’s how we get better outcomes. Therefore, ensuring that nurses are well versed in both relationship skills — the soft skills, emotional intelligence skills — and clinical skills is necessary to navigating our complex healthcare system. We need to look at issues and ask, “How can I solve this?” or “How can I frame your problem in another way?” or “How can I look at it a little bit differently in order to get the solutions and make the case for what we need?”

What do you do to relax?

I enjoy reading and dancing. Having time for quiet reflection. Playing with my cat, Pepper. Traveling, trying out different authentic foods, walking. Last but not least I love spending quality time with friends and family — especially my grandson, Luke.